Background and aims Breast cancer patients have a very high incidence of chronic pain after mastectomy. a risk factor for chronification of pain is severe postoperative pain. the novel erector spinae plane block (ESPB) is considered to be a safer technique than the paravertebral block (PVB) for postoperative thoracic pain.

Methods 20 patients were prospectively included: 10 patients received a PVB and 10 patients received a ESPB. Induction and maintenance of anesthesia, PONV prophylaxis and a complementary multimodal postoperative pain regimen was standardized for all patients. When the numeric rating scale of pain was >3, rescue medication was administered. Study parameters were opioid use in the first 24h; piritramide in the recovery room and oxycodone on the ward. Furthermore, discomfort experienced during placement of the block and overall postoperative patient satisfaction were scored using a numeric rating scale from 0 to 10.

Results Patients received on average 8 mg (PVB) and 4,5 mg (ESPB) piritramide in the recovery room. In the first 24 hours postoperatively, patients received an additional 5,65 mg (PVB) and 1 mg (ESPB) oxycodone. Discomfort was rated as 3 in the PVB group and 1,7 in the ESPB group, satisfaction as 6,75 versus 8,6 respectively.

Conclusions This prospective study was performed to demonstrate the feasibility of the ESPB. Although the study is underpowered for statistical comparisons, the results consistently suggest a better profile in favor of the ESPB. Randomized and adequately powered studies are necessary to confirm this hypothesis.